Provider Demographics
NPI:1033740717
Name:B HOMECARE INC.
Entity Type:Organization
Organization Name:B HOMECARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HERBST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-401-9466
Mailing Address - Street 1:626 MAIN ST N
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MN
Mailing Address - Zip Code:55008-1271
Mailing Address - Country:US
Mailing Address - Phone:763-689-8984
Mailing Address - Fax:763-689-1170
Practice Address - Street 1:626 MAIN ST N
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MN
Practice Address - Zip Code:55008-1271
Practice Address - Country:US
Practice Address - Phone:763-689-8984
Practice Address - Fax:763-689-1170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA717902100Medicaid
MNA172457100Medicaid